Application Must Be Completed by the Applicant. Please Type Or Print Clearly

Application Instructions:

·  Return completed applications and all accompanying documents to Becky Ballard of Human Resources at Digi-Key (see address above) by Friday, April 14, 2017.

·  Application must be completed by the applicant. Please type or print clearly.

·  Retain a copy of the completed application for your records.

·  Attach a copy of your Accuplacer test scores from Northland Community and Technical College (NCTC).

·  Upon Digi-Key’s receipt of your application, you may be contacted to come to Digi-Key’s facility for pre-employment testing (approximately two (2) hours of time to complete job specific tests).

·  If you have any questions about the application or scholarship, please call Becky Ballard at (218)-681-6674, ext. 1340.

Please type or print clearly.

Name ______

Present Address ______

Street if needed, apt. #

______

City State Zip Code

Home Phone # ______Other # ______

Permanent Address ______

Leave blank if same as above Street

______

City State Zip Code

Initial Date Anticipated/Enrolled at NCTC-TRF: ______

Please indicate Program or Major: ______

Expected NCTC Graduation Date: ______

***Attach a copy of your most recent high school transcript, college transcript, or home-school assessment scores. ***

School Name & Address ______

Class Rank ______Class Total ______GPA (4.0 scale) ______

Page 2

Essay – Please type or print clearly.

***On a separate page, in one document, please respond to all of the following items in a total of fewer than 500 words. Remember to include your name on the separate page.
Please attach your responses to this application form.

1.  Describe any community-based service or activities that you’ve been involved with in the past (neighborhood, community, clubs, organizations, employers, and others).

2.  Describe your long-range educational and career goals.

3.  Explain why this scholarship may help you meet your educational goals.

Certification

I have read all the terms and conditions for the Digi-Key Corporation Technical Scholarship program. I certify that the information on this application is true and correct to the best of my knowledge and grant my permission for the information contained herein to be shared with the Digi-Key Corporation Scholarship Committee. If awarded a Digi-Key Corporation scholarship, I must meet and maintain all eligibility requirements. If awarded a Digi-Key Corporation scholarship, I release to Digi-Key Corporation and its assigns the irrevocable, unrestricted and perpetual right to use and publish my name and photo (and any reproductions, modifications or adaptations thereof, collectively “Photographs”) in any and all media now or hereafter known, for publications, reports, press releases, or any other purpose worldwide, without any compensation to me. I agree that Digi-Key Corporation shall have all rights of ownership in the Photographs, and I hereby relinquish any right that I may have to examine or approve the products, publications, advertising material or any other manner in or with which the Photographs may be used. I hereby release and discharge Digi-Key Corporation and its assigns from all claims and liability relating to use of the Photographs or relating to the photographing of me.

Signature of Applicant: ______Date ______

Digi-Key Corporation is an Equal Opportunity / Affirmative Action Employer